Provider Demographics
NPI:1801387881
Name:COUNSELORS PLUS - INDIVIDUAL FAMILY AND RELATIONSHIP COUNSELING INC.
Entity Type:Organization
Organization Name:COUNSELORS PLUS - INDIVIDUAL FAMILY AND RELATIONSHIP COUNSELING INC.
Other - Org Name:COUNSELORS PLUS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-365-6968
Mailing Address - Street 1:405 PRIMROSE RD STE 208
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4091
Mailing Address - Country:US
Mailing Address - Phone:925-365-6968
Mailing Address - Fax:
Practice Address - Street 1:405 PRIMROSE RD STE 208
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4091
Practice Address - Country:US
Practice Address - Phone:925-365-6968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty